DopamineSick Posted March 30, 2017 Share Posted March 30, 2017 Effexor is the only med that's ever worked for me, but it doesn't work anymore. I have tried several SSRI's and they do absolutely nothing. I have suggested Cymbalta several times and each time, the response is "they're in the same class." Well no shit, Sherlock!! That's precisely why I want to try it. If the only other med that's ever worked for me is a SNRI, then why not try another SNRI? People switch between different SSRI's all the time and people switch between Effexor, Cymbalta, and Fetzima as well. Is this woman really a psychiatrist? What kind of logic is this? I'm at a loss with this and I'm running out of options. Link to comment Share on other sites More sharing options...
jt07 Posted March 30, 2017 Share Posted March 30, 2017 What does your psychiatrist suggest you switch to? I'm moving this to the antidepressants board since it is about medications. Link to comment Share on other sites More sharing options...
DopamineSick Posted March 30, 2017 Author Share Posted March 30, 2017 I won't know until my next appointment but I suspect she will keep me on Effexor. The last two appointments/ med changes have been additions (to Effexor) that didn't pan out. The last was wellbutrin and I couldn't tolerate it so I had to stop. I'm not exactly looking forward to doing a taper with possible withdrawal symptoms, but I don't see the point in staying on Effexor either if it isn't doing anything. I know she won't go for a MAOI because I've mentioned it before and she brushed it off. I think that would be too much "trouble" for her because of the "risks." I've also never tried a TCA. But she has insinuated that we're just about out of things to try, as crazy as that sounds. I have tried Rexulti (new Abilify), by the way. This leaves me in a tough spot. Having to find a new doctor right now just feels like a huge endeavor. She's already my third doctor in a relatively short time frame. Besides, what if the new doctor is just as bad or worse? Link to comment Share on other sites More sharing options...
mikl_pls Posted March 30, 2017 Share Posted March 30, 2017 (edited) What's your Effexor dosage? You can go up to 375 mg, and some people go up to anywhere from 450 mg to 600 mg, but from what I've read of your pdoc, I doubt she'd do that... Edited March 30, 2017 by mikl_pls Link to comment Share on other sites More sharing options...
DopamineSick Posted March 30, 2017 Author Share Posted March 30, 2017 1 hour ago, mikl_pls said: What's your Effexor dosage? You can go up to 375 mg, and some people go up to anywhere from 450 mg to 600 mg, but from what I've read of your pdoc, I doubt she'd do that... I'm at 225 mg and she won't go above that for some unapparent reason. This pdoc sticks to only approved maximum doses in the literature. She's not very flexible in her approaches at all. I think 225 mg used to be the ceiling but I know people regularly go above that. I can ask her about it, but I doubt she will do it. I'm at a point where I think it's necessary to get a new doctor, but it's a shot in the dark. All I can do is get a list of doctors from my insurance but then it's just like picking a name out of a hat. I'm not sure what I'll get. Link to comment Share on other sites More sharing options...
mikl_pls Posted March 30, 2017 Share Posted March 30, 2017 http://labeling.pfizer.com/showlabeling.aspx?ID=100 Official Effexor XR PI sheet — look under 2.1 Major Depressive Disorder. Check out what it says in the second paragraph. Maybe she needs to see that if you ask and she says no. Link to comment Share on other sites More sharing options...
sugarsugar Posted March 31, 2017 Share Posted March 31, 2017 Sometimes a new pdoc is the answer but so painful to switch. I finally switched to one who specialized in mood disorders and that helped immensely. And fyi Effexor did nothing for me, Cymbalta was a miracle for my mood, so yes they aren't identical. (But YMMV of course). Link to comment Share on other sites More sharing options...
Iceberg Posted March 31, 2017 Share Posted March 31, 2017 I don't think your all out of options yet...remeron, you could supplement with seroquel or abilify, pristiq- similar to Effexor, brintellix (SSRI ish but still), viibryd. I'm not saying do a thousand med trials....I'm saying don't lose hope Link to comment Share on other sites More sharing options...
DopamineSick Posted March 31, 2017 Author Share Posted March 31, 2017 39 minutes ago, Iceberg said: I don't think your all out of options yet...remeron, you could supplement with seroquel or abilify, pristiq- similar to Effexor, brintellix (SSRI ish but still), viibryd. I'm not saying do a thousand med trials....I'm saying don't lose hope Problem is, my doctor seems clueless. A couple appointments ago, she basically implied that we are more or less out of options. At the last appointment, she said she had "a couple" other ideas. Sorry, but like you just pointed out, there are more than just "a couple" options. I have tried Pristiq and it didn't work. Rexulti helped slightly but made me restless - I'm guessing it might work better if I was taking an antidepressant that actually worked somewhat. Wellbutrin made me feel worse. And I'm wondering if I should call her out on this Effexor to Cymbalta issue, challenge her on it. People switch between those two all the time. In fact, I have a friend who had Effexor poop out on him. He switched to Cymbalta and he's been doing great for the last 3 years. If only an SNRI has ever worked for me, it just makes logical sense to try a different SNRI. I just feel like I'm running out of time. There's only so much I can take. Even in the best case scenario, if I found some combo that worked, I'd still have to wait 6-12 weeks to feel it. This has been going on for the past 6 years and has intensified over the past year. I know I need to stay patient and hopeful but that becomes harder and harder with each failed med trial. This chronic, treatment-resistant depression (and GAD) is unbearable. I wouldn't wish this on anyone. I wish I had "episodes." That way, at least I could have some breaks sometimes. Link to comment Share on other sites More sharing options...
Iceberg Posted March 31, 2017 Share Posted March 31, 2017 Have you tried seroquel+ ad? not for me but it does have approval...and might be less restless than rexulti Also it's good for anxiety Link to comment Share on other sites More sharing options...
DopamineSick Posted March 31, 2017 Author Share Posted March 31, 2017 I haven't taken seroquel long term. I've taken it on a short term basis and it made me feel weird. I wouldn't be opposed to trying it, but I don't think it's going to be much help unless I change to an AD that actually works. If the AD isn't working at all, these additional drugs don't have much of a chance, IMO. Link to comment Share on other sites More sharing options...
Iceberg Posted March 31, 2017 Share Posted March 31, 2017 perhaps a second opinion? Link to comment Share on other sites More sharing options...
DopamineSick Posted March 31, 2017 Author Share Posted March 31, 2017 7 minutes ago, Iceberg said: perhaps a second opinion? That's probably what's going to have to happen. I just hope the next one is better. Link to comment Share on other sites More sharing options...
Iceberg Posted March 31, 2017 Share Posted March 31, 2017 I wish you luck with that Link to comment Share on other sites More sharing options...
mcjimjam Posted April 14, 2017 Share Posted April 14, 2017 If I had no confidence in my doctor and she didn't seem to be determined to return me to functioning I would find a new one. Get a recommendation from a therapist or family doc. As for cymbalta it is in the class but that's kind of a moot point if she's not prepared to try the other classes of AD (maoi and TCa for instance). That said there are probably meds quite different to Effexor and aren't a Maoi or TCA that you could try. Mood stabilisers can treat depression, either alone or to boost the efficacy of conventional antidepressants. Lamictal, lithium, Seroquel and Abilify are some examples. If Effexor is partially effective, it makes sense that she wants to add something to it, rather than switch it for another AD. Link to comment Share on other sites More sharing options...
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